Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair

Scott, Jeffrey R.; Deeken, Corey R.; Martindale, Robert G.; Rosen, Michael J.

doi:10.1007/s00464-016-5057-9

Cited by 54 publications

(53 citation statements)

References 32 publications

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“…The absorbable synthetic mesh Bio-A (Gore) is a copolymer of polyglycolic acid and trimethylene carbonate in a three-dimensional matrix, which completely degrades in approximately 6 months [ 25 ]. Phasix (Bard/Davol) is a macroporous, fully absorbable synthetic mesh that consists of co-knitted absorbable poly-4-hydroxybutyrate and Phasix ST (Bard/Davol) is a composite mesh with additional polyglycolic acid fibers coated with a chemically modified sodium hyaluronate, carboxymethylcellulose, and polyethylene glycol-based hydrogel on the visceral surface [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…Phasix (Bard/Davol) is a macroporous, fully absorbable synthetic mesh that consists of co-knitted absorbable poly-4-hydroxybutyrate and Phasix ST (Bard/Davol) is a composite mesh with additional polyglycolic acid fibers coated with a chemically modified sodium hyaluronate, carboxymethylcellulose, and polyethylene glycol-based hydrogel on the visceral surface [ 26 ]. It has a complete resorption time of 12–18 months [ 25 ]. The macroporous multifilament absorbable synthetic mesh TIGR Matrix Surgical mesh (Novus Scientific) has also been recently introduced on to the market.…”

Section: Methodsmentioning

confidence: 99%

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What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

Köckerling

Alam

Antoniou

et al. 2018

Hernia

141

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IntroductionAlthough many surgeons have adopted the use of biologic and biosynthetic meshes in complex abdominal wall hernia repair, others have questioned the use of these products. Criticism is addressed in several review articles on the poor standard of studies reporting on the use of biologic meshes for different abdominal wall repairs. The aim of this consensus review is to conduct an evidence-based analysis of the efficacy of biologic and biosynthetic meshes in predefined clinical situations.MethodsA European working group, “BioMesh Study Group”, composed of invited surgeons with a special interest in surgical meshes, formulated key questions, and forwarded them for processing in subgroups. In January 2016, a workshop was held in Berlin where the findings were presented, discussed, and voted on for consensus. Findings were set out in writing by the subgroups followed by consensus being reached. For the review, 114 studies and background analyses were used.ResultsThe cumulative data regarding biologic mesh under contaminated conditions do not support the claim that it is better than synthetic mesh. Biologic mesh use should be avoided when bridging is needed. In inguinal hernia repair biologic and biosynthetic meshes do not have a clear advantage over the synthetic meshes. For prevention of incisional or parastomal hernias, there is no evidence to support the use of biologic/biosynthetic meshes. In complex abdominal wall hernia repairs (incarcerated hernia, parastomal hernia, infected mesh, open abdomen, enterocutaneous fistula, and component separation technique), biologic and biosynthetic meshes do not provide a superior alternative to synthetic meshes.ConclusionThe routine use of biologic and biosynthetic meshes cannot be recommended.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

Köckerling

Alam

Antoniou

et al. 2018

Hernia

141

View full text Add to dashboard Cite

show abstract

“…14,15 The Phasix TM ST Mesh (CR Bard, Inc.) is composed of poly-4hydroxybutyrate, it is resorbed in 52 weeks, and its clinical usage is still limited. 16 The study was preceded by empirical selection among experimental mesh samples, which differed by the material (polydioxanone [PDO], PGA, polylactide and poly(lactide-coglycolide)), filament thickness and knitting mode. Sample PDO and PGA meshes produced by warp knitting have been selected because of their high tensile strength, availability, and easy handling meshes produced by warp knitting (the selection procedure is not presented in the article).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of resorbable polydioxanone and polyglycolic acid meshes in a rat model of ventral hernia repair

et al. 2018

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The objective of this study was to evaluate physical, mechanical, and biological properties of the polydioxanone (PDO) monofilament meshes and polyglycolide (PGA) polyfilament meshes in comparison with Permacol implants. In rat experimental model, a 1.5 × 2.0 cm defect in abdominal wall was reconstructed by using the Permacol surgical implant or knitted meshes produced from either PDO monofilament, or PGA multifilament. The implant sites were assessed for the tensile strength and the extents of material resorption, host inflammatory response and host tissue replacement on days 3, 10, 30, or 60 after the surgery. The PDO and PGA meshes were rapidly pervaded by the host connective tissue with elements of skeletal muscle histogenesis. The degree of adhesions was significantly higher in the Permacol group. All of the prostheses underwent resorption, which correlated with gradual decreases in the overall tensile strength of the site and the Col1a1 gene expression level. Elevated expression of Fgf2 gene maintained longer in the PDO group, and the Mmp9 gene expression level in this group was higher than in the other groups. Gene expression levels of inflammatory cytokines were higher in the Permacol group. The foreign body giant cell numbers were lower in the PDO and Permacol groups than in the PGA group. Minimal macrophage infiltration with predominance of M2 cells was observed in the PDO group. Overall, the PDO prosthesis turned out to be significantly better than the PGA or Permacol prostheses by a number of indicators of biocompatibility and efficacy. © 2018 The Authors Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 00B: 000-000, 2018.

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“…In a preclinical study, Phasix TM ST Mesh was implanted in an intraperitoneal (underlay) fashion in a porcine model of ventral hernia repair [7]. Phasix TM ST Mesh-repaired sites exhibited similar postimplantation strength and histological characteristics as partially resorbable (Ventralight TM ST Mesh) and fully resorbable (Phasix TM Mesh) meshes at 12 and 24 weeks postimplantation.…”

Section: Introductionmentioning

confidence: 99%

Mechanical and Histological Characteristics of Phasix™ ST Mesh in a Porcine Model of Hernia Repair

Deeken¹,

Gagne

Badhwar

2020

Journal of Investigative Surgery

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Purpose: The objective of this study was to determine mechanical and histological properties of Phasix TM ST Mesh in various defect sizes and characterize the tissue replacing Phasix TM ST Mesh in a porcine model of ventral hernia repair. Methods: Simulated hernia defects were surgically created in the midline of twenty-four (n ¼ 24) Yucatan pigs. Treatment groups included 8 cm defect sutured closed (buttress) and unclosed 4 cm and 8 cm defect groups. Phasix TM ST Mesh (15 cm diameter circle) was implanted laparoscopically and fixated circumferentially with SorbaFix TM Absorbable Fixation System fasteners. The repair sites underwent mechanical, molecular weight, and histological evaluation at 48 and 72 weeks postimplantation. Results: Mechanical testing of Phasix TM ST Mesh-repaired sites revealed similar strengths at both time points for all three repair types, p > 0.05 in all cases (48 weeks: 142.4 ± 6.0 N, 142.3 ± 16.5 N, and 168.8 ± 38.5 N; 72 weeks: 110.0 ± 18.3 N, 138.6 ± 42.2 N, and 160.6 ± 42.0 N for 4 cm defect, 8 cm defect, and 8 cm buttress, respectively. mean ± SEM) No significant differences were observed over time except at 72 weeks postimplantation when the 4 cm defect group exhibited significantly lower strength than the T 0 strength of Phasix TM ST Mesh (204.6 ± 5.0 N, p < 0.05). The molecular weight of Phasix TM ST Mesh decreased over time, regardless of repair type. Histological analysis showed comparable mature collagen/fibrovascular tissue around and within the Phasix TM ST Mesh interstices, including the segment of mesh overlying the defect. Conclusion: Phasix TM ST Mesh-repaired sites exhibited similar mechanical strengths and histological properties across all defect sizes in this porcine model.

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Evaluation of a fully absorbable poly-4-hydroxybutyrate/absorbable barrier composite mesh in a porcine model of ventral hernia repair

Cited by 54 publications

References 32 publications

What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

What is the evidence for the use of biologic or biosynthetic meshes in abdominal wall reconstruction?

Evaluation of resorbable polydioxanone and polyglycolic acid meshes in a rat model of ventral hernia repair

Mechanical and Histological Characteristics of Phasix™ ST Mesh in a Porcine Model of Hernia Repair

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